阿仑单抗和那他珠单抗治疗不同阶段多发性硬化症患者的疗效。
Efficacy of alemtuzumab and natalizumab in the treatment of different stages of multiple sclerosis patients.
作者信息
Wang Li, Qi Chun-Hui, Zhong Ren, Yuan Chao, Zhong Qiu-Yue
机构信息
Department of Pharmacy, Jining No.1 People's Hospital, Jining Department of Pharmacy, Weifang People's Hospital, Weifang Department of Neurology, Zhucheng People's Hospital, Zhucheng, P.R. China.
出版信息
Medicine (Baltimore). 2018 Feb;97(8):e9908. doi: 10.1097/MD.0000000000009908.
BACKGROUND
Multiple sclerosis (MS) is an autoimmune disease, in which the insulating covers of nerve cells in the brain and spinal cord are demyelinated. This study was conducted to compare the efficacy of alemtuzumab and natalizumab in the treatment of different stages of MS patients.
METHODS
A total of 585 patients diagnosed with MS and hospitalized were included and analyzed after which they were divided into the primary progressive MS A and B groups, the relapsing-remitting MS (RRMS) C and D groups, and the secondary progressive MS E and F groups. Patients in A, C, and E groups were administered alemtuzumab while those in B, D, and F groups were administered natalizumab for the treatment. The expanded disability status scale (EDSS) scores and the EDSS difference were calculated before and after treatment. The number of head magnetic resonance imaging enhanced lesions in the patients, recurrence time and recurrence rate were measured before and after treatment.
RESULTS
The EDSS score of the RRMS group was significantly lower than that of the primary progressive MS group and the secondary progressive MS group. After 12 months of treatment, the EDSS score of RRMS patients treated with natalizumab was significantly lower compared with the patients with alemtuzumab, and the difference before and after treatment was significantly higher than alemtuzumab. The recurrence rate of the RRMS-D group was significantly lower than the RRMS-C group. After 12 months of treatment, compared with the RRMS-C group, a significant reduction was observed in the number of head magnetic resonance imaging enhanced lesions and longer recurrence time in the RRMS-D group.
CONCLUSION
The efficacy of natalizumab was better than alemtuzumab in the treatment of patients in the RRMS group, while there was no significant difference among other stages of MS patients, which provided the theoretical basis and clinical guidance for the treatment of different stages of MS.
背景
多发性硬化症（MS）是一种自身免疫性疾病，其中脑和脊髓神经细胞的绝缘覆盖层会发生脱髓鞘。本研究旨在比较阿仑单抗和那他珠单抗治疗MS患者不同阶段的疗效。
方法
共纳入585例确诊为MS并住院的患者，分析后将其分为原发性进展型MS A组和B组、复发缓解型MS（RRMS）C组和D组、继发性进展型MS E组和F组。A、C和E组患者接受阿仑单抗治疗，而B、D和F组患者接受那他珠单抗治疗。计算治疗前后的扩展残疾状态量表（EDSS）评分及EDSS差值。测量患者治疗前后头部磁共振成像增强病灶数量、复发时间和复发率。
结果
RRMS组的EDSS评分显著低于原发性进展型MS组和继发性进展型MS组。治疗12个月后，接受那他珠单抗治疗的RRMS患者的EDSS评分显著低于接受阿仑单抗治疗的患者，且治疗前后的差值显著高于阿仑单抗。RRMS-D组的复发率显著低于RRMS-C组。治疗12个月后，与RRMS-C组相比，RRMS-D组头部磁共振成像增强病灶数量显著减少，复发时间延长。
结论
那他珠单抗治疗RRMS组患者的疗效优于阿仑单抗，而在MS患者的其他阶段之间无显著差异，这为MS不同阶段的治疗提供了理论依据和临床指导。
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